Medlock Vale Medical Practice

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

The provider demonstrated that patients were key when it came to decisions about their care and treatment choices which were made in partnership and in response to need. We saw that they sought feedback and listed to information about those most likely to experience inequality in experience or outcomes. They proved how they tailored the care, support and treatment in response to feedback and adjusted their systems to ensure that access to care, support and treatment was available to people when they needed it. They understood the complexities of their local community and were making inroads to ensuring that all patients had access to better health.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a good understanding of the local population and complied with the accessible information standards. They had arrangements in place to identify peoples’ communication needs and preferences. There were mechanisms in place for collecting and acting on patient feedback. However, patients continued to report difficulty accessing an appointment and accessing the practice by telephone with no improvement on patient feedback in the national GP patient survey since the last inspection. The provider had taken action to recruit more clinical staff and had trialled a new appointment system which was due to be implemented in May 2024. However, these were not sufficiently embedded to be able to demonstrate patient impact at the time of the assessment.

The provider was able to demonstrate that people were at the centre of their care and treatment choices. They made changes according to feedback and discussed things with them where appropriate. They responded to complaints. They held clinical meetings where care and treatment was discussed. In addition and on reflection the provider expressed their views on feedback received from patients and what they would put in place and do differently in the future which included the involvement of a greater patient participation group with more diversity and inclusion.

The practice understood the diverse health and care needs of people in their local community and we saw that care was joined-up and supported choice and continuity. We were told how staff were trained in the basic skills to identify a patient's individual needs by asking basic open questions during the registration process and first contact with the patient. Staff were familiar with the patients they saw on a regular basis some having worked at the practice for a long time. Managers demonstrated how patient's individual needs were assessed and reviewed so that their care needs were met. The leaders talked about initiatives and what was available to patients to support them to live healthier lives.

This practice had historically been one of the lower rated practices on the General Practice Patient Survey for patient access. Practice quality outcome framework (QOF) achievements in asthma, heart failure and COPD were higher than Greater Manchester and national averages as well as for most diabetes indicators. Data from source showed that the practice had variable achievement in some cancer indicators compared to NHS England averages. NHS England shared two complaints outcome letters for complaints received by two patients of the practice in 2023 and in both instances the professional advisor felt that the care provided by the practice was appropriate.

The practice had an up to date equality, diversion and inclusion policy relevant to staff and patients. Staff understood the diverse health and care needs of people. Health and wellbeing checks were undertaken, self referral to counselling was available and support was in place for staff and patients. Staff were trained in equality, diversity and human rights. All patients were treated equally and fairly and were not discriminated against. The practice welcomed all patients to register with the practice and were happy to make reasonable adjustments to meet patient needs. Patients' needs were recorded and added to alerts clearly so all staff were aware of any adjustments a patient may need. A quiet room was available along with Saturday appointments for patients requiring less stimulation. There was a process to print all letters in braille if required and to offer language line, sign language interpreters and long appointments if needed.

We did not look at Providing Information during this assessment. The score for this quality statement is based on the previous rating for Responsive.

74% of patients who completed the GP patient survey felt the healthcare professional was good at giving them enough time​. This was lower than the local and national average of 84%. 80% of patients who completed the GP patient survey felt the healthcare professional was good at listening to them. This was lower than the local and national average of 85%. 90% of patients who completed the GP patient survey felt they were involved as much as they wanted to be in decisions about their care and treatment​. This was the same as the local and national average of 90%.

Whilst on site we sat and spoke with staff and observed reception staff dealing with patients. We were shown a quality improvement plan in place to improve the way reception and administration staff worked with patients. Staff knew how to assist patients who wanted to make a complaint or provide feedback about their care and treatment. We saw that people were involved in how their care and treatment was processed. We saw that changes were made as a result of patient feedback such as the improvement in the way reception staff dealt with patients.

There were several processes to receive feedback from patients such as complaints, incidents, the GP patient survey, inhouse reviews, SMS messages and compliments. There were also processes to act on that feedback and effect change which happened through supervision, training, clinical meetings, administration meetings and regular updates. There were processes to feedback to patients via the complaints review and also via the patient participation group which the provider acknowledged as something that was under review for improvement.

The surgery offered a mixture of routine appointments and acute on the day access as well as protected daily slots for children under 5. Once capacity had been reached under 5s and over 75s were risk assessed by a GP and could be "squeezed in" if required. Patients could book appointments over the telephone, face to face in the surgery, or online and via the booking link sent to them in SMS to book an advanced appointment. Home visits were booked over the phone and triaged by clinicians. The appointment system was reviewed on an ongoing basis, and the practice took feedback from patients, clinicians and staff to ensure that the clinics and access for patients was maximised. At the time of the site visit leaders fed back and demonstrated improvements made to the appointment system.

Data and insight showed negative responses in the following areas. The percentage of respondents to the GP patient survey who were satisfied with the appointment (or appointments) they were offered (55% achieved 72% expected). The percentage of respondents to the GP patient survey who responded positively to the overall experience of making an appointment (17% achieved 54% expected). The percentage of respondents to the GP patient survey who were very satisfied or fairly satisfied with their GP practice appointment times (24% achieved 52% expected). The percentage of respondents to the GP patient survey who responded positively to how easy it was to get through to someone at their GP practice on the phone (4% achieved 49% expected) This data showed a significant decrease in the patient survey feedback since 2019.

The provider demonstrated changes made to the appointment system, quality improvement programmes and training for reception and administration staff which would all benefit patients. These changes were being introduced because the provider recognised by the feedback from patients that there was a need to improve and we saw evidence of this. The changes to practice were not yet embedded enough to demonstrate improvement.

We saw from the processes in place that the practice was actively looking for and listening to information about people who were most likely to experience inequality in experience or outcomes. They had processes in place to tailor the care, support and treatment in response to this.

We did not look at Planning for the future during this assessment. The score for this quality statement is based on the previous rating for Responsive.